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SoP Library › Obstructive and reflux nephropathy

Statement of Principles

Obstructive and reflux nephropathy — DVA SoP factors

Every factor in the Repatriation Medical Authority Statements of Principles for Obstructive and reflux nephropathy. DVA can only accept a claim for Obstructive and reflux nephropathy if at least one of these factors is met and connected to your service. Reasonable Hypothesis (RH) applies to operational service; Balance of Probabilities (BoP) applies to peacetime service.

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Source: Repatriation Medical Authority Statements of Principles as held by the Veterans Health Centre. SoPs are amended and replaced regularly; always confirm the current instrument at rma.gov.au before relying on it.

Obstructive and reflux nephropathy

RH No. 85 of 2019 · BoP No. 86 of 201918 factors

Meaning of obstructive and reflux nephropathy: For the purposes of this Statement of Principles, obstructive and reflux nephropathy: (a) means an acquired mechanical or functional impediment to normal urine flow, with urinary stasis and elevation in urinary tract pressure, causing: (i) clinical or biochemical evidence of impaired renal function or renal parenchymal damage; or (ii) calyceal deformity, or dilatation of the ureter (hydroureter) or renal pyelocalyceal system (hydronephrosis); and (b) includes renal scarring due to acquired vesicoureteric reflux; and (c) excludes acute, transient urinary retention not due to a fixed mechanical obstruction. (3) While obstructive and reflux nephropathy attracts ICD-10-AM code N13, in applying this Statement of Principles the meaning of obstructive and reflux nephropathy is that given in subsection (2). (4) For subsection (3), a reference to an ICD-10-AM code is a reference to the code assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM), Tenth Edition, effective date of 1 July 2017, copyrighted by the Independent Hospital Pricing Authority, ISBN 97

Reasonable Hypothesis (RH) — Statement of Principles No. 85 of 2019

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting obstructive and reflux nephropathy or death from obstructive and reflux nephropathy with the circumstances of a person's relevant service:

  1. (1)
    having upper urinary tract obstruction, due to partial or complete blockage of the renal pelvicalyceal system, ureter or ureteropelvic junction on the affected side, before the clinical onset of obstructive and reflux nephropathy;

    Note: Examples of causes of upper urinary tract obstruction include, but are not limited to, renal stone disease, benign or malignant neoplasm, faecal impaction, and complications of an indwelling ureteric stent.

  2. (2)
    having lower urinary tract obstruction, due to partial or complete blockage of the bladder outlet or urethra, before the clinical onset of obstructive and reflux nephropathy;

    Note: Examples of causes of lower urinary tract obstruction include, but are not limited to, benign or malignant neoplasm of the prostate, bladder or urethra; benign prostatic hyperplasia; urethral sling; and urethral stricture or stenosis.

  3. (3)
    having a renal or ureteric transplant on the affected side, before the clinical onset of obstructive and reflux nephropathy;
  4. (4)
    having neurogenic bladder at the time of the clinical onset of obstructive and reflux nephropathy;

    Note: neurogenic bladder is defined in the Schedule 1 - Dictionary.

  5. (5)
    having upper urinary tract obstruction, due to partial or complete blockage of the renal pelvicalyceal system, ureter or ureteropelvic junction on the affected side, before the clinical worsening of obstructive and reflux nephropathy;

    Note: Examples of causes of upper urinary tract obstruction include, but are not limited to, renal stone disease, benign or malignant neoplasm, faecal impaction, and complications of an indwelling ureteric stent.

  6. (6)
    having lower urinary tract obstruction, due to partial or complete blockage of the bladder outlet or urethra, before the clinical worsening of obstructive and reflux nephropathy;

    Note: Examples of causes of lower urinary tract obstruction include, but are not limited to, benign or malignant neoplasm of the prostate, bladder or urethra; benign prostatic hyperplasia; urethral sling; and urethral stricture or stenosis.

  7. (7)
    having a renal or ureteric transplant on the affected side, before the clinical worsening of obstructive and reflux nephropathy;
  8. (8)
    having neurogenic bladder at the time of the clinical worsening of obstructive and reflux nephropathy;

    Note: neurogenic bladder is defined in the Schedule 1 - Dictionary.

  9. (9)
    inability to obtain appropriate clinical management for obstructive and reflux nephropathy;

Aggravation-only factors: the factors in subsections 9(5) to 9(9) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.

Balance of Probabilities (BoP) — Statement of Principles No. 86 of 2019

9 factors

At least one of the following factors must exist before it can be said that, on the balance of probabilities, obstructive and reflux nephropathy or death from obstructive and reflux nephropathy is connected with the circumstances of a person's relevant service:

  1. (1)
    having upper urinary tract obstruction, due to partial or complete blockage of the renal pelvicalyceal system, ureter or ureteropelvic junction on the affected side, before the clinical onset of obstructive and reflux nephropathy;

    Note: Examples of causes of upper urinary tract obstruction include, but are not limited to, renal stone disease, benign or malignant neoplasm, faecal impaction, and complications of an indwelling ureteric stent.

  2. (2)
    having lower urinary tract obstruction, due to partial or complete blockage of the bladder outlet or urethra, before the clinical onset of obstructive and reflux nephropathy;

    Note: Examples of causes of lower urinary tract obstruction include, but are not limited to, benign or malignant neoplasm of the prostate, bladder or urethra; benign prostatic hyperplasia; urethral sling; and urethral stricture or stenosis.

  3. (3)
    having a renal or ureteric transplant on the affected side, before the clinical onset of obstructive and reflux nephropathy;
  4. (4)
    having neurogenic bladder at the time of the clinical onset of obstructive and reflux nephropathy;

    Note: neurogenic bladder is defined in the Schedule 1 - Dictionary.

  5. (5)
    having upper urinary tract obstruction, due to partial or complete blockage of the renal pelvicalyceal system, ureter or ureteropelvic junction on the affected side, before the clinical worsening of obstructive and reflux nephropathy;

    Note: Examples of causes of upper urinary tract obstruction include, but are not limited to, renal stone disease, benign or malignant neoplasm, faecal impaction, and complications of an indwelling ureteric stent.

  6. (6)
    having lower urinary tract obstruction, due to partial or complete blockage of the bladder outlet or urethra, before the clinical worsening of obstructive and reflux nephropathy;

    Note: Examples of causes of lower urinary tract obstruction include, but are not limited to, benign or malignant neoplasm of the prostate, bladder or urethra; benign prostatic hyperplasia; urethral sling; and urethral stricture or stenosis.

  7. (7)
    having a renal or ureteric transplant on the affected side, before the clinical worsening of obstructive and reflux nephropathy;
  8. (8)
    having neurogenic bladder at the time of the clinical worsening of obstructive and reflux nephropathy;

    Note: neurogenic bladder is defined in the Schedule 1 - Dictionary.

  9. (9)
    inability to obtain appropriate clinical management for obstructive and reflux nephropathy;

Aggravation-only factors: the factors in subsections 9(5) to 9(9) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.

A VHC Diagnostic Assessment addresses each of these factors one by one against your service record and clinical history. See how a VHC DVA claim works, see all fees ($600 + GST per stage) or book an appointment.

About Dr Thomas Perkins

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Founding doctor of the Veterans Health Centre in Ipswich, Queensland, and one of Australia's most experienced practitioners in veterans' medicolegal medicine.

Dr Perkins has spent more than thirteen years working exclusively with current and former ADF members — treating their conditions, writing their reports and navigating the DVA system alongside them. With over 100,000 claims submitted and 2,000 Permanent Impairment Assessments completed, he has seen precisely what separates an accepted claim from a rejected one at every level, from initial liability to the Veterans' Review Board.

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